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Perceptions of Health Professionals in Ghana on the Role of the Community in Chronic Disease Management

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Perceptions of Health Professionals in Ghana on the Role of the Community in Chronic Disease Management Georgia Southern University Digital Commons@Georgia Southern Electronic Theses and Dissertations Graduate Studies, Jack N. Averitt College of Summer 2018 Perceptions of Health Professionals in Ghana on the Role of the Community in Chronic Disease Management Jesuseme Omoruan Follow this and additional works at: https://digitalcommons.georgiasouthern.edu/etd Part of the Cardiovascular Diseases Commons, Community Health and Preventive Medicine Commons, International Public Health Commons, and the Public Health Education and Promotion Commons Recommended Citation Omoruan, Jesuseme, "Perceptions of Health Professionals in Ghana on the Role of the Community in Chronic Disease Management" (2018). Electronic Theses and Dissertations. 1820. https://digitalcommons.georgiasouthern.edu/etd/1820 This dissertation (open access) is brought to you for free and open access by the Graduate Studies, Jack N. Averitt College of at Digital Commons@Georgia Southern. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Digital Commons@Georgia Southern. For more information, please contact [email protected]. PERCEPTIONS OF HEALTH PROFESSIONALS IN GHANA ON THE ROLE OF THE COMMUNITY IN CHRONIC DISEASE MANAGEMENT by JESUSEME OMORUAN (Under the Direction of Bettye Apenteng) ABSTRACT The prevalence of chronic disease has been on the rise in various developing countries. This study is an exploratory investigation of the perceptions of health professionals in Kumasi, Ghana on the role of the community in chronic disease management. Using the Chronic Care Model and the Expanded Chronic Care Model as frameworks, the objective of the study was to examine the extent of community-healthcare system in chronic disease management and to explore the barriers to and facilitators of community involvement in chronic disease management. By exploring the availability of community resources that positively contribute to the management of these patients, the study fills an existing gap in the literature related to community involvement in chronic disease management. The study used a mixed methods approach, utilizing both qualitative and quantitative data. Data were obtained from interviews with 50 healthcare professionals and a quantitative survey of 109 healthcare professionals. Research findings revealed that the family unit is the main form of support for patients with chronic diseases. Findings additionally revealed a lack of community support, resources, and community partnerships in the efforts towards effective health management for patients with chronic diseases in Ghana. KEY WORDS: Chronic disease, Ghana, Health management, Healthcare, Health professionals, Health system PERCEPTIONS OF HEALTH PROFESSIONALS IN GHANA ON THE ROLE OF THE COMMUNITY IN CHRONIC DISEASE MANAGEMENT by JESUSEME OMORUAN B.A., University of Washington, 2012 M.P.H., Georgia Southern University, 2014 A Dissertation Submitted to the Graduate Faculty of Georgia Southern University in Partial Fulfillment of the Requirements for the Degree DOCTOR OF PUBLIC HEALTH STATESBORO, GEORGIA 2018 JESUSEME OMORUAN All Rights Reserved 1 PERCEPTIONS OF HEALTH PROFESSIONALS IN GHANA ON THE ROLE OF THE COMMUNITY IN CHRONIC DISEASE MANAGEMENT by JESUSEME OMORUAN Major Professor: Bettye Apenteng Committee: Evans Afriyie-Gyawu Joanne Chopak-Foss Samuel Opoku Electronic Version Approved: July 2018 2 DEDICATION My dissertation is dedicated to my family and close friends who have been my number one supporters and a pivotal key to my success. I would also like to dedicate my dissertation to my late grandfather, Dr. JC Omoruan who I wish could have witnessed me trail behind in his academic footsteps. 3 ACKNOWLEDGMENTS With all of the trials and tribulations as it pertains to my health, my family has been my absolute rock through everything and I am so appreciative of each one of them. Thank you, Mom, Dad, Aira, and Ebie, for being my constant support system through it all, I honestly don’t know what I would have done without you. To my dissertation committee, I am so fortunate and lucky to have had the chance to learn from all of your expertise throughout this process. I would like to especially thank my chair, Dr. Bettye Apenteng, for working with me while I was across the country in Seattle. None of this would have been possible without you, the lessons and knowledge I have gained are endless and I’ll forever be grateful. I would like to acknowledge my study abroad group from the Ghana Study Abroad Program, everyone that helped me during that summer, thank you so much. Also, a big thank you to everyone at Komfo Anokye Teaching Hospital and all the people we met in Ghana. Lastly, Dr. Evans Afriyie-Gyawu, thank you for having me in the program and being so supportive throughout the years. To all the friends I made at GSU and to my professors, thank you for the sense of community and shared support! 4 TABLE OF CONTENTS Page ACKNOWLEDGMENTS ............................................................................................................................ 3 LIST OF TABLES ........................................................................................................................................ 5 LIST OF FIGURES ...................................................................................................................................... 6 CHAPTER I .................................................................................................................................................... 7 Purpose of the study ............................................................................................................... 9 Significance of the study ...................................................................................................... 10 CHAPTER II – LITERATURE REVIEW .................................................................................................. 13 Global burden of chronic diseases ................................................................................... 13 Burden of chronic diseases in sub-Saharan Africa .......................................................... 16 Chronic disease management in Africa ........................................................................... 17 Burden of chronic diseases in Ghana............................................................................... 20 Chronic disease management in Ghana ........................................................................... 23 Organization of the health care delivery system .............................................................. 24 Clinical management of chronic conditions .................................................................... 25 The chronic care model and chronic conditions .............................................................. 33 Conclusion ....................................................................................................................... 36 CHAPTER III – CONCEPTUAL FRAMEWORK .................................................................................... 38 Chronic care model .......................................................................................................... 38 CHAPTER IV - METHODOLOGY ........................................................................................................... 48 Study design .................................................................................................................... 48 Study population and sample ........................................................................................... 49 Qualitative instrument ..................................................................................................... 50 Quantitative instrument ................................................................................................... 51 Ethical considerations ...................................................................................................... 58 CHAPTER V - RESULTS .......................................................................................................................... 60 Quantitative & qualitative findings ................................................................................. 62 CHAPTER VI - DISCUSSION .................................................................................................................. 82 Recommendations ........................................................................................................... 98 Future research ................................................................................................................ 95 Conclusion ..................................................................................................................... 101 REFERENCES ......................................................................................................................................... 104 APPENDIX A ........................................................................................................................................... 118 APPENDIX B ........................................................................................................................................... 120 APPENDIX C ........................................................................................................................................... 122 5 LIST OF TABLES TABLE 1.1 Definition of terms ....................................................................................................................................
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